To Solve the Opioid Crisis, Address Demand, Not Just Supply

Topics: Compliance, Government, Government Fraud Blogs, Leadership, Risk Management, Thomson Reuters

opioid

More than 100 people a day die from drug overdoses in the United States, two-thirds of them from opioids in various forms. The most lethal of these are the synthetic opioid fentanyl (which is 50-times stronger than heroin) and its even more potent cousin carfentanil, which is twice as strong as fentanyl.

Fentanyl is so powerful that an amount equal to three grains of salt can kill a human being. People die from it primarily by taking heroin laced with fentanyl and accidentally overdosing, because they have no way of knowing how much of the drug they are ingesting.

A Powerful Epidemic Turns into a National Security Issue

In the Mexican drug cartels primarily responsible for supplying opioids to the United States, heroin cut with fentanyl is known as El Diablito — the little devil. Last year, US Customs and Border patrol agents confiscated 1,485 pounds of fentanyl at American ports of entry, and by May of this year they had already seized 1,060 pounds. Yet it’s estimated that these amounts represent only 3% to 5% of the fentanyl coming into this country.

The word “epidemic” is regularly used to describe the nature of the opioid problem, but to many people on the front lines of this battle, the escalating nature of the threat should be thought of as no less than a matter of national security — with opioids themselves viewed as “weapons of mass destruction.”

Among those sounding this alarm the loudest is Peter Vincent, who is the former Principal Legal Advisor for the U.S. Department of Homeland Security (DHS) detailed to the U.S. Immigration and Customs Enforcement (ICE) division and formerly serving as ICE’s Senior Counselor for International Policy. Vincent worked on the ground in Colombia and Afghanistan trying to disrupt the cultivation and distribution of narcotics.

“I view opioids cumulatively as a weapon of mass destruction — and the opioid crisis itself as a national security issue — because of the number of lives lost and destroyed,” says Vincent, who now serves as General Counsel for Thomson Reuters Special Services.

opioids

Peter Vincent, General Counsel for Thomson Reuters Special Services

He notes that only 3,500 lives have been lost in the U.S. due to direct acts of terrorism since 1975 (the vast majority of which occurred in the 9/11 terrorist attacks), whereas upwards of 60,000 people a year die from drug overdoses.

“I tend to see everything through a national security prism,” he explains. “The destruction left by drug addiction in the United States is an extraordinarily real threat to our way of life, to our security, and to our democracy. We are hollowing out entire communities through the over-prescription of opioids and the subsequent search by addicted individuals for illegal substitutes such as heroin and fentanyl.”

The Social Costs of Opioid Addiction

Opioids don’t simply affect the people who take them. As the Centers for Disease Control & Prevention (CDC) Principal Deputy Director Anne Schuchat has observed. “No area of the United States is exempt from this epidemic,” she said in a CDC statement. “We all know a friend, family member, or loved one devastated by opioids.”

Indeed, one of the most insidious aspects of the opioid problem is how it impacts the entire social structure of people in its grip, as well as the strain it puts on law enforcement, emergency responders, hospitals, social-service providers, healthcare professionals, and many others whose jobs involve trying to keep people from killing themselves.

The social costs are staggering. According to a 2017 report by the White House Council of Economic Advisers (CEA), the opioid epidemic costs more than $500 billion per year — if one factors in additional healthcare costs of survivors and the lost income potential of people who die. Despite these daunting statistics, law enforcement and government policies continue to focus on stanching the supply of fentanyl and prosecuting drug dealers who peddle it.

Addressing the Real Culprit: Demand

According to Thomson Reuters’ Vincent, however, this approach alone will not work, and has never worked — as Prohibition and the failed “War on Drugs” both attest. Furthermore, it ignores the larger, more crucial side of the drug-abuse equation: demand.

“We cannot investigate, prosecute, and incarcerate our way out of this tragedy,” says Vincent. “We need to shift the balance so that we are spending money more effectively and efficiently. Specifically, we need to be spending it more on addressing why people are taking these drugs, and how to get them off the drugs.”

Asking why so many people in the United States consume opioids is a question almost no one raises, says Vincent, because “it would require admitting to ourselves that we have enormous systemic problems, and that we are not devoting enough resources to deal with the tragic reality of the post-modern, post-industrial world we live in now.”

Looking at the Cycle of Poverty

Many communities ravaged by opioids are also communities that have lost jobs due to changing dynamics in the economy, where unemployment is high, educational opportunities are scarce, and people have little or no access to healthcare. This cycle of poverty and despair drives much of the demand for opioids, says Vincent, because drugs provide an escape, however temporary, from lives of perpetual misery.

People need “meaning” and “purpose” in their lives, he continues, and the only way to give such purpose back to drug addicts is to provide resources for treatment, job training, educational opportunities, housing for the neediest, and healthy ways to integrate addicts back into the fabric of their families and communities.

“We need to be investing massive resources into addressing the social and economic challenges in the United States that are part of the addiction dynamic,” says Vincent, adding that includes restructuring the US justice system to stop “shaming and blaming and incarcerating” addicts and instead provide counseling and assistance to those who need it.


For more information, you can follow Peter Vincent on Twitter @AttyPVincent.